广西医学

目的分析疑似脑血管疾病住院患者的脑血管血流动力学异常的发生情况及其影响因素。方法选取在某康复医院住院并接受脑血管血流动力学检测的646例疑似脑血管疾病患者，通过检测脑血管血流动力学指标（CVHI）及其积分了解患者脑血管血流动力学情况。应用多因素Logistic回归模型分析CVHI积分的影响因素。比较血压正常和血压异常患者的CVHI。结果（1）646例患者中，有324例（50.15%）CVHI积分正常（积分正常组），有322例（49.85%）CVHI积分异常（积分异常组）。积分异常组有高血压病史、有糖尿病病史、血压异常的患者比例高于积分正常组（P<0.05）。多因素Logistic回归分析结果显示，有高血压病史、有糖尿病病史、血压异常是CVHI积分异常的危险因素（P<0.05）。（2）646例患者中，有423例（65.48%）血压正常（血压正常组），有223例（34.52%）血压异常（血压异常组）。血压正常组体质指数<18.5 kg/m2、18.5~<24.0 kg/m2的患者比例及CVHI积分高于血压异常组（P<0.05）。血压异常组左右侧脑血管脉搏波、脑血管特性阻抗、脑血管外周阻力、动态阻力、舒张压与临界压差及左侧平均血流量高于血压正常组，左右侧脑血管扩张度指标、临界压低于血压正常组（P<0.05）。结论在疑似脑血管疾病住院患者中，约有50%出现脑血管血流动力学异常。血压异常、有高血压病史及糖尿病病史是脑血管血流动力学异常的危险因素。血压水平与CVHI和CVHI积分密切相关，应密切关注血压异常者的脑血管血流情况，做好脑血管疾病的预防工作。

Objective To analyze the occurrence of cerebral vascular hemodynamic abnormalities and its influencing factors in inpatients with suspected cerebrovascular diseases. Methods A total of 646 inpatients with suspected cerebrovascular diseases who was admitted and underwent cerebral vascular hemodynamic testing in a rehabilitation hospital were selected. Cerebral vascular hemodynamic status was assessed using the cerebral vascular hemodynamic index (CVHI) and its integrated score. Multivariate Logistic regression model was employed to identify factors influencing the CVHI score. CVHI parameters were compared between patients with normal blood pressure and those with abnormal blood pressure. Results (1) Among the 646 patients, 324 (50.15%) had a normal CVHI score (the normal score group), while 322 (49.85%) had an abnormal CVHI score (the abnormal score group). The proportions of patients with a history of hypertension, diabetes, and abnormal blood pressure were higher in the abnormal score group than in the normal score group (P<0.05). The results of multivariate Logistic regression analysis indicated that history of hypertension, diabetes, and abnormal blood pressure were risk factors for an abnormal CVHI score (P<0.05). (2) Among the 646 patients, 423 (65.48%) had normal blood pressure (the normal blood pressure group), and 223 (34.52%) had abnormal blood pressure (the abnormal blood pressure group). The proportions of patients with a body mass index<18.5 kg/m² and 18.5-<24.0 kg/m², as well as the CVHI score, were higher in the normal blood pressure group than in the abnormal blood pressure group (P<0.05). The abnormal blood pressure group showed higher values for left and right cerebral vascular pulse wave velocity, cerebrovascular characteristic impedance, cerebrovascular peripheral resistance, dynamic resistance, diastolic⁃to⁃critical pressure difference, and left mean blood flow, while the left and right cerebrovascular compliance indices and critical pressure were lower compared to the normal blood pressure group (P<0.05). Conclusion Approximately 50% of inpatients with suspected cerebrovascular diseases exhibit cerebral vascular hemodynamic abnormalities. Abnormal blood pressure, history of hypertension and diabetes are risk factors for these abnormalities. Blood pressure levels are closely associated with CVHI parameters and the CVHI score. Close monitoring of cerebral vascular hemodynamics in individuals with abnormal blood pressure is essential for the prevention of cerebrovascular diseases.

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